What is Vasovagal ( VVS) syncope?

VVS is the most common form of fainting occurring mostly in young adults, though it can occur at any age. It’s also called reflex, neurocardiogenic, neurally mediated syncope or vasodepressor syncope.

It happens when the nervous system that regulates blood pressure and heart rate malfunctions in response to a trigger, causing the heart rate and blood pressure to drop , resulting in fainting .

Vasovagal Syncope In young adults

• It is more common in women 17- 30 age , with low body weight . Even though causes a lot of distress for patients , it’s a benign condition, that typically does not require treatment .

• VVS typically happens after prolonged standing and is often preceded by a sensation of warmth, nausea, lightheadedness, tunnel vision . It was initially described in situations involving prolonged standing , such as weddings or church .

• VVS syncope can be triggered by violent coughing (especially in men), laughing , swallowing.

Vasovagal Syncope In elderly

• In older people VVS may be triggered by straining during defecation ( moving your bowels), micturition( urination) , sudden changes in positions , such as standing up too fast .

• It’s seen more often in elderly with Parkinson’s , Diabetes , or other neurological disorders that have in common autonomic dysfunctions

• Some medications can predispose to VVS , such as blood pressure drugs and prostrate medications

What causes vasovagal syncope?

• Standing for long periods

• Excess heat

• Intense emotion, such as fear

• Intense pain

• The sight of blood or a needle

• Prolonged exercise

• Dehydration

• Skipping meals

• Urinating

• Swallowing

• Coughing

• Having a bowel movement

Diagnosis of VVS

The diagnosis of VVS involves ruling out other possible causes fainting. Tests usually ordered include:

•Electrocardiogram

•Holter monitor

•Echocardiogram.

•Exercise stress test.

•Blood tests.

•Tilt table test . For this test, you lie on a padded table. Heart rate and blood pressure are monitored while you are lying down and then tilted up for a period of time. Sometime medicine is also given to trigger a fainting response. If you have vasovagal syncope, you may faint during the upward tilt.

Treatment of VVS

• Recognize early symptoms ( like dizziness, nausea, or sweaty palms.) and lie down right the way, raising or propping up your legs in the air

• Avoiding triggers, such as standing for a long time

• Discontinuing medicines that lower blood pressure, like diuretics

• Eating a higher salt diet, to help keep up blood volume

• Drinking plenty of fluids, to maintain blood volume – 8 glasses a water per day .

• Wearing compression stockings

Sometimes a trial of medications may be recommended

• Corticosteroids, to help increase the sodium and fluid levels- Fludrocortisone

• Serotonin reuptake inhibitors (SSRIs), to moderate the nervous system response